Talk to Hematologist on Polysyethemia
Asking for Father, Male, 75 years old, Karachi
my father has suffered due to policythemia Rubra Vera since last 9 years, since last 1 year he has pain in mouth ( lip and tounge). He can't eat easily due to pain. under Treatment oncologist and also Skin specilist. His mouth is better but same problem not cleared) Please suggest me to whom he should be checked (Skin specilist or Dentist) Sultan Karachi.
Assoc. Prof. Dr. Mubashir Razzaq Khan - Hematologist
MBBS, M.Phil (Hematologist), PhD | Faisalabad
#Elevated_Haemoglobin
Elevated haemoglobin is seen in smokers, living at high altitudes, congestive cardiac failure, chronic obstructive pulmonary disease, Some erythropoietin secreting adenomas of kidney, and very rarely it could be a part of #primary_polycythaemia. Rule out the causes of #secondary_polycythaemia. If all Causes are excluded, Get #JAK2, #Exon12, and #CALR mutations tested. Even in primary polycythaemia also called polycythaemia rubra vera, these mutations are negative frequently. In cases of secondary polycythaemia the treatment of elevated haemoglobin is to treat the cause. In primary polycythaemia if JAK2 is negative, the treatment is #therapeutic–Phlebotomy or #venesection. The goal is to keep #haemoglobin and #haematocrit within range that is for male, less than 50 haematocrit and for a female less than 48. And haemoglobin in mail 16 and then female up to 15 g/dL. It can be combined with #hydroxyurea which dose could be calculated according to Weight of the patient. Repeated Vensections Or phlebotomies can lead to micro nutrient deficiency especially iron. The patient should be given micronutrient replacement therapy. For JAK2 positive Patients, #Ruxolitinib_Jakavi Tablets are given in a dose of 5 to 15 mg per day. Other option is #IFN_alpha (Pegasys) in low dose (45 ug/week) in both JAK2 positive or negative cases. CALR positive cases show superior results on this mode. It could take years to cure the disease. Meanwhile, along with all therapeutic modalities, #thrombophilia_prophylaxis is given. This is not a life threatening disease. The patient can die with this but doesn’t die of it.
Assoc. Prof. Dr. Mubashir Razzaq Khan - Hematologist
MBBS, M.Phil (Hematologist), PhD | Faisalabad
364 Positive Reviews
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Dr. Ayesha Shahid Siddiqui - Hematologist
MBBS , FCPS (Hematologist Training), PGCFM | Lahore
87 Positive Reviews
Aoa , please share your reports .Apart from polycythemia , he should get his mouth properly examined for any disease.It should be cleared by a ENT and Dental Surgeon both.
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